How expensive is medication? Does insurance cover it? Discounts?

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    • #83959
      DCT2019
      Participant

      If I decide to take medication if it turns out that I have ADHD (I’m meeting with my doctor next week) I worry about the finances of it. I’m on my father’s health insurance (Blue Cross Blue Shield). If our insurance covers the meds, will it cover it at a full price or just knock the price down? How much should I be expecting to pay out of pocket? How much would copayment probably be? Do discounts knock down the price even more if insurance covers it?

      For example, give me an estimate of how much I would be expecting to pay for a prescription of Vyvanse with insurance and after a discount? Can you do the same for Adderall XR? I’m interested in these two medications. I live in Michigan by the way (The Detroit area) if this helps.

    • #83999
      Penny Williams
      Keymaster

      It depends entirely on your insurance plan. Some only cover certain ADHD meds. Some have a high copy per Rx on stimulants while others are more affordable.

      If the cost to you is high, there are some strategies in this article for affording treatment, including some reputable discount cards and manufacturer discount programs:

      “We Can’t Afford to Treat Our ADHD”

      Penny
      ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism

    • #84056
      got2be
      Participant

      My insurance covered the cost of Methyphenidate (generic Concerta) with a $40 co-pay. There are often three tiers of prices for medication. Vyvanse, Adderall, Concerta would be in the highest tier with a $40-$60 co-pay in my experience. That is a very low price compared to the out-of-pocket cost. If you want the name brand, the insurance company will probably send a form for your doctor to fill out. If you don’t have insurance, GoodRx.com and SingleCare.com are good ways to find discounts from local pharmacies. If you meet the low-income requirements, Vyvanse has the Shirecares program which will cover your costs. For example you can get 30 Vyvanse capsules per month at no cost for a year. You re-apply after one year. You and your doctor will need to fill out the application. You can see the Shirecares details and application at http://bit.ly/2Kd2Ehi

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